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Tramadol (Ultram, Tramal (see below)) is a centrally-acting analgesic, used for treating moderate to moderately severe pain. The drug has a wide range of applications, including treatment for restless leg syndrome, acid reflux, and fibermyosis. Tramadol possesses agonist actions at the ?-opioid receptor and inhibits the reuptake of norepinephrine and serotonin. Tramadol is a compound with mild and delayed. Tramadol is a synthetic stripped-down piperidine-analog of the phenantherane alkaloid codeine and, as such, is an opioid and also a pro-drug (codeine is metabolized to morphine, tramadol is converted to M-1 aka O-desmethyltramadol). Opioids are chemical compounds which act upon one or more of the human opiate receptors (the euphoria, addictive nature and respiratory depression are mainly caused by the Mu(?) 1 and 2 receptor. The opioid agonistic effect of Tramadol and its major metabolite(s) are almost exclusively mediated by the substance's action at the ?-opioid receptor. 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